Associations Between Body Anthropometric Measures and Severity of Carpal Tunnel Syndrome

Mondelli, Mauro; Curti, Stefania; Mattioli, Stefano; Aretini, Alessandro; Ginanneschi, Federica; Greco, Giovanna; Farioli, Andrea

doi:10.1016/j.apmr.2016.03.028

Cited by 18 publications

(14 citation statements)

References 63 publications

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“…Moreover, in a study of carpal tunnel characteristics performed with magnetic resonance imaging, women turned out to have a smaller carpal tunnel area and a smaller free space in carpal tunnel ( Bower et al , 2006 ). Recent studies confirmed that certain hand/wrist anthropometric configurations are associated with increased risk and severity of CTS ( Mondelli et al ., 2014 , 2015 , 2016a , 2016 b). Among anthropometric factors, body mass index is a well-known determinant of CTS ( Shiri et al , 2015 ); it might also increase the detrimental effect of biomechanical exposures ( Burt et al , 2013 ; Shiri et al , 2015 ).…”

Section: Discussionmentioning

confidence: 99%

“…In Italy, a 4- to 5-fold increase in risk was observed for women compared with men for both CTS diagnosis and surgery ( Mondelli et al , 2002 ; Violante et al , 2007 ; Mattioli et al , 2008 ). In the past, several epidemiological studies have been conducted to identify plausible sex-specific causes of CTS, possibly including hormonal factors, pregnancy, anthropometric characteristics, and non-occupational biomechanical exposures ( Dieck and Kelsey, 1985 ; Padua et al , 2010 ; Apostoli et al , 2012 ; Mondelli et al , 2016a ). Intriguingly, lower sex ratios were observed for CTS diagnosis in large cohort studies of industrial workers where the exposure to biomechanical risk factors was carefully assessed ( Kapellusch et al ., 2014 ; Violante et al , 2016 ).…”

Section: Introductionmentioning

confidence: 99%

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Observed Differences between Males and Females in Surgically Treated Carpal Tunnel Syndrome Among Non-manual Workers: A Sensitivity Analysis of Findings from a Large Population Study

Farioli

Curti

Bonfiglioli

et al. 2018

Annals of Work Exposures and Health

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ObjectivesWe aimed at assessing whether differences among males and females in carpal tunnel syndrome (CTS) epidemiology might be attributable to segregation with respect to occupational biomechanical exposures or differential access to care by sex.MethodsWe analysed surgically treated cases of CTS occurring among non-manual workers in Tuscany between 1997 and 2000. We conducted a Monte Carlo simulation to estimate the difference in occupational biomechanical exposures between males and females necessary to explain the observed incidence rate ratios. We also accounted for the sex-specific probability of receiving surgery after the diagnosis of CTS, as women were reported to be more likely to undergo surgery in a subset of our study population. We quantified the hypothetical biomechanical overload through the hand activity level (HAL) metric proposed by the American Conference of Governmental Industrial Hygienists. To quantify the effect of HAL on CTS risk, we assumed a prior distribution based on findings from two large cohort studies of industrial workers.ResultsAfter adjustment for the probability of receiving surgery, women showed a 4-fold incidence of CTS as compared with men. To explain this association among non-manual workers, women should have an average value of HAL at least 5 points higher.ConclusionsOur analysis does not support the hypothesis that the difference in CTS incidence between males and females is entirely attributable to occupational risk factors or to differential access to surgery. The causal pathway between sex and CTS might include more determinants such as hormonal factors, anthropometric characteristics, and non-occupational exposure to biomechanical overload (e.g. household tasks).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Observed Differences between Males and Females in Surgically Treated Carpal Tunnel Syndrome Among Non-manual Workers: A Sensitivity Analysis of Findings from a Large Population Study

Farioli

Curti

Bonfiglioli

et al. 2018

Annals of Work Exposures and Health

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“…The associations between selected anthropometric and obesity indexes and CTS severity have been recently reported [ 35 ]. The authors found that all the studied hand and wrist indexes were associated with both clinical and electrophysiological severity.…”

Section: Discussionmentioning

confidence: 99%

“…The authors found that all the studied hand and wrist indexes were associated with both clinical and electrophysiological severity. Whereas, among the adiposity indexes, the waist/stature ratio showed the strongest association with CTS severity [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Severity of Carpal Tunnel Syndrome and Diagnostic Accuracy of Hand and Body Anthropometric Measures

Mondelli¹,

Farioli

Mattioli

et al. 2016

PLoS ONE

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ObjectiveTo study the diagnostic properties of hand/wrist and body measures according to validated clinical and electrophysiological carpal tunnel syndrome (CTS) severity scales.MethodsWe performed a prospective case-control study. For each case, two controls were enrolled. Two five-stage clinical and electrophysiological scales were used to evaluate CTS severity. Anthropometric measurements were collected and obesity indicators and hand/wrist ratios were calculated. Area under the receiver operating characteristic curves (AUC), sensitivity, specificity, and likelihood ratios were calculated separately by gender.ResultsWe consecutively enrolled 370 cases and 747 controls. The wrist-palm ratio, waist-hip-height ratio and waist-stature ratio showed the highest proportion of cases with abnormal values in the severe stages of CTS for clinical and electrophysiological severity scales in both genders. Accuracy tended to increase with CTS severity for females and males. In severe stage, most of the indexes presented moderate accuracy in both genders. Among subjects with severe CTS, the wrist-palm ratio presented the highest AUC for hand measures in the clinical and electrophysiological severity scales both in females (AUC 0.83 and 0.76, respectively) and males (AUC 0.91 and 0.82, respectively). Among subjects with severe CTS, the waist-stature ratio showed the highest AUC for body measures in the clinical and electrophysiological severity scales both in females (AUC 0.78 and 0.77, respectively) and males (AUC 0.84 and 0.76, respectively). The results of waist-hip-height ratio AUC were similar.ConclusionsWrist-palm ratio, waist-hip-height ratio and waist-stature ratio could contribute to support the diagnostic hypothesis of severe CTS that however has to be confirmed by nerve conduction study.

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“…The lifetime prevalence of musculoskeletal problems of the upper extremities in professions involving intensive or repetitive manual work, including desktop workers, dental hygienists, [1][2][3][4] professional sportsmen, [5][6][7] and musicians, is high (up to 55%). 8,9 These problems frequently interfere seriously with work performance and even with careers.…”

Section: Introductionmentioning

confidence: 99%

Reliability of an instrument for screening hand profiles: The Practical Hand Evaluation

Woldendorp

Schipper

Boonstra

et al. 2018

Journal of Hand Therapy

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Associations Between Body Anthropometric Measures and Severity of Carpal Tunnel Syndrome

Cited by 18 publications

References 63 publications

Observed Differences between Males and Females in Surgically Treated Carpal Tunnel Syndrome Among Non-manual Workers: A Sensitivity Analysis of Findings from a Large Population Study

Observed Differences between Males and Females in Surgically Treated Carpal Tunnel Syndrome Among Non-manual Workers: A Sensitivity Analysis of Findings from a Large Population Study

Severity of Carpal Tunnel Syndrome and Diagnostic Accuracy of Hand and Body Anthropometric Measures

Reliability of an instrument for screening hand profiles: The Practical Hand Evaluation

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